Teeth for a Lifetime
Thanks to better at-home care and in-office
dental treatments, more people than ever
before are keeping their teeth throughout
their lives. Although some diseases and
conditions can make dental disease and tooth
loss more likely, most of us have a good
deal of control over whether we keep our
teeth into old age.

The most important thing you can do to
maintain good oral health is to brush and
floss your teeth regularly.

Most mouth woes are caused by plaque, that
sticky layer of microorganisms, food
particles and other organic matter that
forms on your teeth. Bacteria in plaque
produce acids that cause cavities. Plaque
also leads to periodontal (gum) disease, a
potentially serious infection that can erode
bone and destroy the tissues surrounding
teeth.

The best defense is to remove plaque daily
before it has a chance to build up and cause
problems. Brushing removes plaque from the
large surfaces of the teeth and, if done
correctly, from just under the gums.
Flossing removes plaque between teeth.

Brushing
Most of us learned to brush our teeth when
we were children and have kept the same
technique throughout our lives.
Unfortunately, many of us learned the wrong
way. Even if we learned the correct method,
it's easy to become sloppy over the years.
Brushing correctly isn't instinctive.
Getting the bristles to remove plaque
without damaging your gums is a little
trickier than you might think.

There are different ways to brush teeth, and
your dentist or dental hygienist can show
you the method that he or she feels would be
best for you. The modified Bass technique is
among the most popular for adults and is
very effective in removing plaque above and
just below the gum line. Children, however,
may find it difficult to move the toothbrush
this way. A dentist or dental hygienist can
explain to your child the best way to brush.
Parents should supervise their children's
oral hygiene until age 9 or 10.

Here are a few general pointers about
brushing:

Brush at least twice a day — Many
oral health professionals recommend brushing
just before going to bed. When you sleep,
saliva decreases, leaving the teeth more
vulnerable to bacterial acids. Teeth should
also be brushed in the morning, either
before or after breakfast, depending on your
schedule. After breakfast is ideal so food
particles are removed. But if you eat in
your car, at work or skip breakfast
entirely, make sure you brush in the morning
to get rid of the plaque that built up
overnight.

Brush no more than three times a day
— Brushing after lunch will give you a good
mid-day cleaning. Remember, though, that
brushing too often can cause gums to recede
over time.

Brush lightly — Brushing too hard can
cause gums to recede. Plaque attaches to
teeth like jam sticks to a wooden spoon. It
can't be totally removed by rinsing, but
just a light brushing will do the trick.
Once plaque has hardened into calculus
(tartar), brushing can't remove it, so
brushing harder won't help. Try holding your
toothbrush the same way you hold a pen. This
encourages a lighter stroke.

Brush for at least two minutes — Set
a timer if you have to, but don't skimp on
brushing time. Longer is fine, but two
minutes is the minimum time needed to
adequately clean all your teeth. Many people
brush for the length of a song on the radio.
That acts as a good reminder to brush each
tooth thoroughly.

Have a standard routine for brushing
— Try to brush your teeth in the same order
every day. Some oral health professionals
feel that this helps patients remember to
brush all areas of their mouths. If you do
this routinely, it eventually will become
second nature. For example, brush the outer
sides of your teeth from left to right
across the top then move to the inside and
brush rights to left. Repeat the pattern for
your lower teeth.

Always use a toothbrush with "soft" or
"extra soft" bristles — The harder the
brush, the greater the risk of harming gum
tissue.

Change your toothbrush regularly — As
soon as the bristles begin to splay, the
toothbrush loses its ability to clean
properly. Throw away your old toothbrush
after three months or when the bristles
flare, whichever comes first. If you find
your bristles flaring much sooner than three
months, you may be brushing too hard. Try
easing up.

Choose a brush that has a seal of
approval by the American Dental Association
— Oral health-care professionals say, "It's
not the brush, it's the brusher," meaning
that the exact type of brush you use isn't
nearly as important as your brushing
technique and diligence. Any approved brush
will be a good tool, but you have to know
how to use it.

Electric is fine, but not always
necessary — Electric or power-assisted
toothbrushes are a fine alternative to
manual brushes. They are especially useful
for people who are less than diligent about
proper brushing technique or for people with
physical limitations that make brushing
difficult. As with manual brushes, choose
soft bristles, brush for at least two
minutes and don't press too hard or you'll
damage your gums.

Choose the right toothpaste for you —
It can be overwhelming to face the huge
number of toothpaste choices in the average
supermarket. Remember, the best toothpaste
for you may not be the best toothpaste for
someone else.
Toothpastes don't merely clean teeth
anymore. Different types have special
ingredients for preventing decay, plaque
control, tartar control, whitening, gum care
or desensitizing teeth. Most toothpastes on
the market today contain fluoride, which has
been proven to prevent, stop or even reverse
the decay process. Tartar control
toothpastes are useful for people who tend
to build up tartar quickly, while someone
who gets tooth stains may want a whitening
toothpaste. Whitening toothpastes will
remove only surface stains, such as those
caused by smoking, tea or coffee. To whiten
teeth that are stained at a deeper level,
talk with your dentist. Your needs will
likely change as you get older, so don't be
surprised if your hygienist recommends a
type of toothpaste you haven't used before.
Look for the ADA seal of approval, which
assures that the toothpaste has met the
standards set by the American Dental
Association. Once these conditions are met,
choose the toothpaste that tastes and feels
best. Gel or paste, wintergreen or spearmint
— these work alike, so let personal
preference guide your decision. Some people
find certain ingredients irritating to
teeth, cheeks or lips. If you find that your
teeth have become more sensitive or that
your mouth is irritated after brushing, try
changing toothpastes. If the problem
continues, see your dentist.

How To Brush

Modified Bass brushing technique:
▪ Hold the head of the toothbrush
horizontally against your teeth with the
bristles part way on the gums.

▪ Tilt the brush head to about a 45-degree
angle, so the bristles are pointing
under the gum line.

▪ Move the toothbrush in very short
horizontal strokes so the tips of the
bristles stay in one place, but the head of
the brush waggles back and forth. Or use
tiny circular motions. This allows the
bristles to slide gently under the gum. Do
this for about 20 strokes. This assures that
adequate time will be spent cleaning away as
much plaque as possible. Note: this is a
very gentle motion. In healthy gums, this
should cause no pain. Brushing too
vigorously or with large strokes can damage
gum tissue.

▪ Roll or flick the brush so that the
bristles move out from under the gum toward
the biting edge of the tooth. This helps
move the plaque out from under the gum line.

▪ Repeat for every tooth, so that all tooth
surfaces and gum lines are cleaned.

▪ For the insides of your front teeth, where
the horizontal brush position is cumbersome,
hold the brush vertically instead. Again,
use gentle back and forth brushing action
and finish with a roll or flick of the brush
toward the biting edge.

▪ To clean the biting or chewing surfaces of
the teeth, hold the brush so the bristles
are straight down on the flat surface of the
molars.

▪ Gently move the brush back and forth or in
tiny circles to clean the entire surface.
Move to a new tooth or area until all teeth
are cleaned.

▪ Rinse with water to clear the mouth of
food residue and removed plaque.

▪ You can clear even more bacteria out of
your mouth by brushing your tongue. With
your toothbrush, brush firmly but gently
from back to front. Do not go so far back in
your mouth that you gag. Rinse again.

Flossing
Many people never learned to floss as
children. But flossing is critical to
healthy gums and it's never too late to
start. A common rule of thumb says that any
difficult new habit becomes second nature
after only three weeks. If you have
difficulty figuring out what to do, ask your
dentist or dental hygienist to give you a
personal lesson.

Here are a few general pointers about
flossing:

Floss once a day — Although there is
no research to recommend an optimum number
of times to floss, most dentists recommend a
thorough flossing at least once a day. If
you tend to get food trapped between teeth,
flossing more often can help remove it.

Take your time — Flossing requires a
certain amount of dexterity and thought.
Don't rush.

Choose your own time — Although most
people find that just before bed is an ideal
time, many oral health professionals
recommend flossing any time that is most
convenient to ensure that you will continue
to floss regularly. Choose a time during the
day when you can floss without haste.

Don't skimp on the floss — Use as
much as you need to clean both sides of
every tooth with a fresh section of floss.
In fact, you may need to floss one tooth
several times (using fresh sections of
floss) to remove all the food debris.

Although there has been no research, some
professionals think reusing sections of
floss may redistribute bacteria pulled off
one tooth onto another tooth.

Choose the type that works best for you
— There are many different types of floss:
waxed and unwaxed, flavored and unflavored,
ribbon and thread. Try different varieties
before settling on one. People with teeth
that are closely spaced will find that waxed
floss slides more easily into the tight
space. There are tougher shred-resistant
varieties that work well for people with
rough edges that tend to catch and rip
floss.

How To Floss
How you hold the floss is a matter of
personal preference. The most common method
is to wind the floss around the middle
fingers then pull it taut and guide it with
your index fingers. You also can wind it
around your index fingers and guide it with
your thumb and middle fingers or simply hold
the ends of the floss or use a floss-guiding
tool. (If you have a fixed bridge, a bridge
threader can help guide floss under the
bridge for better cleaning.) How you hold
the thread is not as important as what you
do with it. If you can't settle in on a good
method, ask your dentist or hygienist for
suggestions.

▪ Hold the floss so that a short segment is
ready to work with.

▪ Guide the floss gently between two teeth.
If the fit is tight, use a back-and-forth
motion to work the floss through the narrow
spot. Do not snap the floss in or you could
cut your gums.

▪ Hold the floss around the front and back
of one tooth, making it into a "C" shape.
This will wrap the floss around the side
edge of that tooth.

▪ Gently move the floss toward the base of
the tooth and up into the space between the
tooth and gum.

▪ Move the floss up and down with light to
firm pressure to skim off plaque in that
area. Do not press so hard that you injure
the gum.

▪ Repeat for all sides of the tooth,
including the outermost side of the last
tooth. Advance the floss to a clean segment
for each tooth edge.

Other Ways To Clean
Between the Teeth
Many people have larger spaces between their
teeth and need additional tools, called
interdental cleaners, to remove food
particles and bacterial plaque adequately.
You may have larger spaces that need extra
care if you have had gum surgery or if you
have teeth that are missing or out of
alignment.

Small interdental brushes are tiny bristle
or filament brushes that can fit between
teeth and come in a variety of sizes and
handle designs. These brushes clean better
than floss when the gum tissue does not
completely fill the space between your
teeth. These little brushes also can help
people with orthodontic bands on their teeth
to remove bacterial plaque from around the
wires and brackets.

Another tool for cleaning between teeth is
wooden interdental cleaners. These long,
triangular strips of wood can be softened
and used to clean between teeth.

You can find these interdental cleaners at
most drugstores and grocery stores. Your
dentist or dental hygienist can show you how
to use these cleaners to remove plaque
between your teeth.

Other Cleaning ToolsTo supplement your at-home brushing and
flossing, your dentist or hygienist may
suggest one or more of the following:

Oral irrigators — These electrical
devices pump water out in a slim steady or
pulsating stream. Although they do not seem
to remove plaque that is attached to the
tooth well, they are very effective at
flushing out food and bacteria byproducts in
periodontal pockets or that get caught in
orthodontic appliances.

They are particularly useful for delivering
medication to hard-to-reach areas. For
example, prescription antibacterial rinses
can be sprayed into gum pockets with an oral
irrigator. Irrigators should be used in
addition to brushing and flossing, not as an
alternative.

Interdental tip — These soft,
flexible rubber nibs are used to clean
between the teeth and just below the gum
line. Plaque and food debris can be removed
by gently running the tip along the gum
line.

Mouthwashes and rinses — As with
toothpaste, your choice of mouthwashes or
rinses will be guided by your personal mouth
care needs. Over-the-counter rinses are
available to freshen the breath, add
fluoride or kill plaque bacteria that cause
gingivitis. Some mouthwashes are designed to
help loosen plaque before you brush. Ask
your dentist or hygienist to recommend the
type of rinse that would be best for you. If
you need to avoid alcohol, read ingredient
labels carefully.

Many over-the-counter mouthwashes contain
significant amounts of alcohol. In some
cases, the dentist might prescribe a
stronger fluoride or antibacterial rinse.